The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / The Art & Science of Imaging the Pediatric Sacroiliac Joint

The Art & Science of Imaging the Pediatric Sacroiliac Joint

November 3, 2021 • By Lara C. Pullen, PhD

  • Tweet
  • Email
Print-Friendly Version / Save PDF

Radiologists and rheumatologists who interpret pediatric pelvic magnetic resonance imaging (MRI) scans must be able to differentiate inflammatory changes from the normal physiologic changes of a maturing sacroiliac (SI) joint. However, this ability varies by specialist, a point highlighted by a new study from Pamela F. Weiss, MD, associate professor of pediatrics and epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, and colleagues. Their findings suggest additional training may be needed for radiologists regarding the appearance of the maturing SI joint on MRI.

You Might Also Like
  • The ACR’s State-of-the-Art Clinical Symposium: Rheumatologists Weigh in on Tough-to-Treat Cases, Paget’s Disease, Imaging
  • EULAR 2013: Emerging Imaging Methods in Spondylarthritis Have Advantages and Flaws
  • Multimodal Imaging May Uncover Neural Mechanisms in Pediatric Neuropsychiatric Lupus
Also By This Author
  • Large Genome Study Identifies Genetic Risk Factors for Gout

Dr. Weiss and colleagues evaluated the agreement between local radiologists’ interpretations of pediatric SI joint MRIs and a central imaging team’s interpretation. Their study was published in the June issue of Arthritis Care & Research.1

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Study Details

The study included the evaluation of the SI joints of 120 children performed in eight pediatric hospitals across North America. With a median age of 14 years, the children had a median disease duration of 0.8 years at the time of imaging. Half the children were male, and the majority were white (76.8%). In addition, the majority of children had a diagnosis of enthesitis-related arthritis (82.4%). The investigators coded the global impression of sacroiliitis based on the impression section of the radiology report. If the impression did not differentiate between active inflammation and chronic sacroiliitis, the researchers looked at the findings section of the radiology report. If bone marrow edema in or along the SI joints was noted in the findings section, then the report was coded as chronic inflammation.

The MRIs were independently reviewed by three experienced musculoskeletal pediatric radiologists serving as the central review team for the study. These three radiologists were selected for their ability to identify inflammatory and structural lesions at the SI joint. The majority of the time (84%), the central radiologists agreed on the presence or absence of active inflammation and chronic lesions. The results of the central review team were compared with reports from the children’s local radiologists. The authors note that no standardized assessment for local interpretation exists, and the imaging quality of the studies reviewed was highly variable—even within the same institution.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

The local reports had a low, positive predictive value of 51.8%. In other words, only 51.8% of the diagnoses of sacroiliitis made locally were confirmed by the centralized readers. Only rarely (2% of the time) did the central radiologists identify active inflammation when the local radiologists did not identify active inflammation. It was much more common (22.5% of the time) for the local radiologists to identify active inflammation and the central radiologists conclude that there was no active inflammation. Thirteen of the studies were missing coronal oblique sequences, making visualization of the synovial section of the joint more difficult than if the sequences were available. However, when investigators performed a sensitivity analysis that excluded all studies with any quality issues or missing coronal oblique sequences, the rates of discordance were approximately the same.

Pages: 1 2 3 | Single Page

Filed Under: Conditions Tagged With: imaging, joint imaging, Pediatric, Radiologist, sacroiliac joints, sacroiliitis, SI joint

You Might Also Like:
  • The ACR’s State-of-the-Art Clinical Symposium: Rheumatologists Weigh in on Tough-to-Treat Cases, Paget’s Disease, Imaging
  • EULAR 2013: Emerging Imaging Methods in Spondylarthritis Have Advantages and Flaws
  • Multimodal Imaging May Uncover Neural Mechanisms in Pediatric Neuropsychiatric Lupus
  • How Magnetic Resonance Imaging Technology Can Aid Spondyloarthritis Diagnosis

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2022 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.